FDA and CDC are continuing their investigation into a multistate outbreak of Cyclospora cayetanensis infections stemming from salads made by Fresh Express and containing iceberg lettuce, red cabbage, and carrots.
As of August 14, CDC has reported 690 cases across 13 states, with 37 hospitalizations and no deaths. The onsets of illness range from May 11, 2020 to July 20, 2020.
Environmental sampling detected the presence of Cyclospora in the surface water of a canal near a farm suspected of being a source of the red cabbage. Two samples collected to the north and south of where the farm accessed canal water for seepage irrigation were found to be positive for Cyclospora cayetanensis. The farm that supplied red cabbage was no longer in production at the conclusion of the growing season, so it was not possible to sample product. Additionally, the farms growing iceberg lettuce in California were investigated and all of the samples collected in California were negative for the pathogen.
Given the emerging nature of genetic typing methodologies for this parasite, FDA has been unable to determine if the Cyclospora detected in the canal is a genetic match to the clinical cases, therefore, there is currently not enough evidence to conclusively determine the cause of this outbreak.